medical wastes. Nonetheless, the composition of medical
waste was found to be in the following decreasing order:
pathological (61.95%) > infectious (28.70%) > chemical
(9.35%). As a percentage of the total solid waste generated
in each hospital, the mean composition was: pathological
waste, 18.74%; infectious waste, 8.68% and chemical waste,
2.91%. A study conducted in India (Patil and Shekdar,
2001) on the average composition of total solid waste in
hospitals found infectious waste ranging from 10–36.23%
with an average of 18.83%; for pathological, the range
was from 4.06–19.71% with an average of 8.1%. The composition
for chemical waste ranged from 0.22–2.77% with
an average of 0.9%. The mean values found in this study
for medical waste composition are therefore not very different
from reported ranges for hospitals in India. In this
study, most of the medical waste was found coming from
maternity and theatre wards, which are known to generate
a large amount of pathological and infectious waste. During
the waste measurements, the amount of pathological
waste was seen to be higher than the amount of infectious
waste, which is consistent with the reported percentage
compositions.
4.4. Waste management practices
4.4.1. Waste collection and segregation
The Department of Health has developed national
guidelines on the management of hospital waste (Kluge,
2001). Color is used to differentiate containers for storing
various types of hospital waste at the generation point
(Table 3). Infectious waste should be stored in a yellow
marked, strong leak proof bag or container. Chemical
and pharmaceutical waste is supposed to be stored in a
brown marked plastic bag or container. Black marked plastic
bags in containers are to be used for storing general
waste. Radioactive waste should be stored in a red lead
box labeled with a radioactive symbol. Sharps are to be
stored in a yellow marked puncture proof container with
covers on them (called bin beez).
Sharps were found to be the only types of waste collected
in the recommended containers in both hospitals.
Infectious, pathological and chemical wastes were all collected
in red plastic bags. This to some extent could be promoting
mixing of these types of wastes during collection, as
was observed in many wards. One reason for using red
plastic bags was that they were less costly and more accessible
compared to other plastic bags recommended by the
Department of Health. In some wards, the site survey also
found that these wastes were also mixed with general waste.
This type of mixing waste was common at Tshilidzini hospital.
Only the intensive care unit and the gynecology unit
in the maternity ward were found to be efficient in separating
the waste into the various types during collection. At
Elim hospital, any general waste found to contain medical
waste was treated as hazardous waste, thus requiring special
handling and management similar to any medical